Organization
CHILDRENS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GUTZEIT MD (PRESIDENT)
(414) 266-3002
Entity
Organization
Contact information
Practice address
9000 W WISCONSIN AVE, MS 958, MILWAUKEE, WI 53226-3518
(414) 266-7615
(414) 266-6238
Mailing address
9000 W WISCONSIN AVE, MS 958, MILWAUKEE, WI 53226-3518
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
122300000X
Dentist
—
—
208000000X
Pediatrics Physician
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790732410
—
WI
Enumeration date
05/28/2006
Last updated
05/21/2025
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